1. Workplace Violence Personal Safety for Rural Health Professionals
“Safety is about going home at the end of the day and being with your loved ones,”
And let me say this in the strongest possible terms, Safety is a basic human right. We all accept that the right to vote, freedom of speech, own property, choose who we marry, how we worship are basic human rights. So is the right to safety. The declaration of independence specifies life, liberty and the pursuit of happiness as inalienable rights. The three right do not exist when and where people aren’t safe. Although some of us will choose to sacrifice our own personal safety to protect the rights of others. Nobody has the right to make you unsafe., nobody.
“We are each responsible for our own safety.”
Who’s here from Security, Risk Management, HR, Emergency Prepardness

2. Learning Objectives Scope & Impact of Workplace Violence
Typology of Workplace Violence & Risk Factors
Recognizing/Avoiding Dangerous People
& Situations
Responding to Threats & Assaults .
Type I- Person has no relationship to the business or its employees; person
is usually robbery, sexual assault or crime usually involved Accounts for approximately
85% of workplace homicides. Risk factors are Working alone
Handling money, Working the nights, poor lighting, High crime areas
Type II- Client/Patient or family member and becomes violent while receiving
care or services Risk factors are alone or with few other present, inadequate security
measures, working with persons with dementia, subtance abusers, severe mental
illness, or history of violence.
TYPE III- Current or former employee, Risk factors, Inadaquate employee
screening, high stress work conditions, WPV policies lacking, weak or not enforced.
TYPE IV_ Current/previous relationship with an employee.
Domestic violence spill over. Lack of access controls, lack of fast help communications and response.

3. Workplace Violence

4. Definition
Workplace violence is any physical assault, threatening behavior, or verbal abuse occurring in the work setting
A workplace may be any location either permanent or temporary where an employee performs any work-related duty
This includes, but is not limited to, the buildings and the surrounding perimeters, including the parking lots, field locations, clients’ homes and traveling to and from work assignments

5. Workplace Violence Includes:
Beatings
Stabbings
Suicides
Shootings
Rapes
Psychological traumas
Threats or obscene phone calls
Intimidation
Harassment of any nature
Being followed, sworn or shouted at

6. Continuum of Violence Insulting Bullying Intimidating Threatening
Warning signs of violent behavior may be classified into three levels.
Not everyone exhibiting warning signs will become violent. However, no warning sign should
be completely ignored. Any one or combination of warning signs, at any level, may indicate
a potentially violent situation.
Level 1: Intimidation
Level 2: Escalating
Level 3: Further Escalation
Level 4 Extreme Escalation
In Level 1, the person exhibits intimidating behaviors that are:
Discourteous/disrespectful,Uncooperative, and/or Verbally abusive.
Level 2 Argues with staff, family, patients and others, Refuse to obey agency policies or procedures.
Sabotage equipment or steal property for revenge. Verbalize wishes to hurt people Stalk, harass, or show
undue focus on another person. Make direct or indirect threats (in person, in writing, by phone).
Views himself or herself as a victim.
Level 3 usually results in some form of emergency response. In such cases, the person displays
intense anger resulting in: Suicidal threats. Physical fights or assaults others
Damage or destruction of property. Concealment or use of a weapon to harm others.
Display of extreme rage or physically aggressive acts, throwing or striking objects,
shaking fists, verbally cursing at others, pounding on desks, punching walls, or angrily
jumping up and down.
Insulting
Bullying
Intimidating
Threatening
Vandalizing
Stalking
Slapping
Shoving
Pinching
Hitting
Kicking
Biting
Weapon Use

7. Statistics on Workplace Violence
Homicide is the second leading cause of death in the workplace
1# among women and supervisors
Assaults and threats of violence number exceed 2 million a year

8. Economic Impact of Workplace Violence
Cost 500,000 employees 1,175,100 lost work days each year
Lost wages: $55 million annually
Lost productivity, legal expenses, property damage, diminished public image, increased security: $ billions $

9. CRIMINAL INTENT Violence Type I
The perpetrator has no legitimate relationship to your business or its employee(s). Violence is incidental to another crime, such as assault, robbery, theft, or burglary.
Most workplace homicides (85 percent)
are Type I violence.
RISK FACTORS:
Handling cash, valuables or drugs
Working alone or isolation
Inadequate security & access controls
High risk neighborhoods & locations
Poorly lit parking areas
Inadequate training
Be clear no fool proof method for predicting violence by strangers. Mental illness, intoxication?
Gut instinct, guesses
Dark, isolated
Capability to harm, physicallity weapons, multiple potential assailents?

10. PATIENT/CUSTOMER/CLIENT (and their families and associates)
Violence Type II
PATIENT/CUSTOMER/CLIENT
(and their families and associates)
Accounts for a majority of nonfatal workplace violence incidents. Victims are often patient care providers.
Healthcare occupations are 18% of workforce BUT 48% of
WPV victims
RISK FACTORS:
Working alone or isolation
Prevalence of guns and other weapons.
Dementia, substance abuse/use & mental illness
Budget cuts for mental health services.
Inadequate training
Be clear no fool proof method for predicting violence by strangers. Mental illness, intoxication?
Gut instinct, guesses
Dark, isolated
Capability to harm, physicallity weapons, multiple potential assailents?

11. Worker On Worker Violence Type III
Employee(or former), vendor or contractor who attacks or threatens employees or former employees.
Worker-on-worker fatalities account for approximately 7 percent of all workplace homicides.
RISK FACTORS:
Inadequate pre-employment screening.
Lack of effective WPV Polices.
Employee terminations.
Inadequate training
Be clear no fool proof method for predicting violence by strangers. Mental illness, intoxication?
Gut instinct, guesses
Dark, isolated
Capability to harm, physicallity weapons, multiple potential assailents?

12. Personal Violence Violence Type III
Perpetrator has no relationship with the business but does with the intended victim. This category includes victims of domestic violence who are assaulted or threatened while at work.
Accounts for about 5 percent
of all workplace homicides.
RISK FACTORS:
Lack of E.A.P. program.
Uncontrolled public access to work space.
Lack of effective WPV Polices.
Inadequate training
Be clear no fool proof method for predicting violence by strangers. Mental illness, intoxication?
Gut instinct, guesses
Dark, isolated
Capability to harm, physicallity weapons, multiple potential assailents?

13. A Simple Model The Fire Triangle
Heat
Air
For many years the fire traiangle has been used to teach how Heat, Air and Fuel are all required for combustion to occur. Take away one and there is no fire or a fire will go out.
Fuel

14. Violence! The Violence Triangle Intent Ability Opportunity
Now the Violance Triangle of ability, intent and opportunity provides a simple easy model avoiding violence and managing to reduce harm should it occur.
Opportunity

15. Awareness Critical for use: Before Entering/Changing Locations
When Traveling
When Encountering Unknown Persons
Before Hiring
He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!"
Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself.
You yourself need to do something.

16. Awareness Tools & Resources” Sex Offender Registry Crime Maps
Criminal Justice Look Ups
Background Checks
Intuition
Who is he?
And what’s he
doing here?
He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!"
Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself.
You yourself need to do something.

17. Actions If Attacked or Threatened
Experts Agree…
The most effective precaution is…
Having a plan ahead of time.
He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!"
Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself.
You yourself need to do something.

18. You’ll NEVER lose a fight
Action #1
Running Away
You’ll NEVER lose a fight
you run away from!
He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!"
Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself.
You yourself need to do something.

19. Action #2 Getting Help Call 911 Coded Distress Signal Security System
Elevators
On the “Street”
He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!"
Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself.
You yourself need to do something.

20. Psychological Barriers
Action #3
Barriers
Indoor Barriers
Outdoor Barriers
Psychological Barriers
He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!"
Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself.
You yourself need to do something.

21. Action #4 Verbal Self Defense Verbal Judo* Redirection Focused Empathy
1. Ask
2. Set Context
3. Offer Options
4. Confirm
5. Next Step
Redirection
Focused Empathy
He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!"
Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself.
You yourself need to do something.
* “Verbal Judo, The Gentle Art of Persuasion”, George J Thompson & Jerry B. Jenkins, HarperCollins 1994

22. 4. MUST NOT CAUSE PAIN OR HARM TO PATIENTS!!!
Action #5
Self Defense
Rules for Self Defense
1. Last Resort
2. Always Full Power
3. Has Only One Purpose
4. MUST NOT CAUSE PAIN OR HARM
TO PATIENTS!!!
He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!"
Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself.
You yourself need to do something.

23. Action #6 Self Defense Tools Firearms Stun Guns Blunt & Edged Weapons
Improvised
Self Defense Spray
He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!"
Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself.
You yourself need to do something.

24. Questions, Comments, Concerns?
Joe Rosner

25. Closing Thought
The most important thing we do today, tomorrow and everyday is to go home safely.

26. CV of Joe Rosner US Army Drug & Alcohol Spec./Unit Police
Private Investigator/Bodyguard
Evanston Park Police Officer
Multiple Black Belts
Founder/Director of Best Defense USA
Author of--
Street Smarts & Self Defense for Children
The Real Estate Safety Book
Taking Care!: Personal Safety for Home Health Workers
Workplace violence can be any act of physical violence, threats of physical violence, harassment, intimidation, or other threatening, disruptive behavior that occurs at the work site. Workplace violence can affect or involve patients, patient families, visitors, vendors, contractors, neighbors and co-workers.

27. Additional Resources www.BestDefenseUSA.com www.gavindebecker.com/
www.
He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!"
Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself.
You yourself need to do something.